Surviving an aortic dissection

"Five hundred dollars?" exclaimed Mark Meris as he tried to steady his gaze on the price tag of an original Transformer Optimus Prime collector’s toy. It was just like the kind he owned when he was a child. The actual tag read $5,500, but his vision was suddenly blurry and intense pain began to creep steadily up his body.

“I felt the most excruciating pain I have ever felt in my life,” says Mark.

While shopping with his family in the middle of a comic book store, Mark struggled to gain his composure. Intense pressure built up from his abdomen, through his chest and back, and around his ribs.

“It was like I was being bear-hugged and crushed in the torso area,” says Mark. “Then it shot up from my chest slowly through my neck, then jawline, then up through my temples. It was hard to breathe.”

A life-threatening diagnosis

Mark's family rushed him to the Sharp Grossmont Hospital Emergency Department. There, staff found that Mark’s blood pressure was very high. He was given medications to ease his pain.

“We performed an echocardiogram and an aortic dissection was suspected,” says Dr. Farah Dawood, a cardiovascular disease specialist affiliated with Sharp Grossmont Hospital. “A CT scan was ordered, and it confirmed the diagnosis of ascending aortic dissection and a ruptured heart valve.”

According to Dr. Seemal Mumtaz, a cardiothoracic surgeon affiliated with Sharp Grossmont, an aortic dissection is a tear in the aorta, the biggest blood vessel that comes out of the heart and supplies blood to the entire body. The part of the aorta that comes out of the heart in the front of the chest is called the ascending aorta.

“A tear in the ascending aorta is life-threatening,” says Dr. Mumtaz. “This can extend to the arteries of the heart and cause a massive heart attack or stroke. It can also extend to the aortic heart valve, causing it to leak or rupture, which can cause sudden death. The only treatment is emergency surgery to save a patient’s life.”

Certain illicit drugs that can increase blood pressure suddenly, such as cocaine or methamphetamine, have been linked with aortic dissection. But Dr. Mumtaz says the most common causes and risk factors for aortic dissection are sudden, very high blood pressure; connective tissue disorders, which can predispose to dissection; or a known family history of aortic dissection.

Saving Mark’s life

Doctors rushed Mark into emergency surgery at Sharp Grossmont Hospital’s Burr Heart & Vascular Center. “I understood that I would have a 1 in 3 chance of not making it during or after surgery,” recalls Mark.

The surgery, which took nearly 12 hours, included replacing his ruptured aorta and leaking heart valve, fixing the dissection and performing bypass heart surgery.

“This is a very complex surgery, where most of the time we have to stop blood flow to the body,” says Dr. Mumtaz. “To do this safely, we have to almost freeze the body to 18º C while the blood flow is stopped. The heart-lung machine is what allows us to do this kind of surgery.”

In Mark’s case, it was not necessary to freeze his body, Dr. Mumtaz says. But the surgery was still complex.

“The tear had made his aortic valve incompetent,” Dr. Mumtaz says. “It had also extended into his right coronary artery, which supplies blood to the right side of the heart. This artery was almost torn to shreds.”

Dr. Mumtaz and her surgical team took a vein from Mark’s leg to bypass the damaged artery. They also replaced the torn aorta with a graft.

“Despite all the damage that the dissection had done to his heart and artery, with the surgery we were able to restart his heart without any problems,” she says. “He was able to come off the heart-lung machine with his own heart beating well.”

The road to recovery

Mark spent 10 days in the hospital’s surgical intensive care unit (SICU) recovering from the effects of the dissection and surgery. After leaving the hospital, he continued with physical and speech therapy at home, which was later followed by therapy at Sharp Grossmont Hospital’s Cardiac Rehabilitation to regain his strength.

“Starting on day 1 of being at home, I could only manage enough strength to walk out to the front of the driveway,” Mark says. “The next day, I made it to the neighbor’s house. Then, the next day, the next neighbor’s house, and so on.”

After two weeks at home, he was able to walk to the end of his neighborhood block. By two months, he was walking 2 to 3 miles.

“I feel great now, still not 100% physically, but maybe high 90%,” says Mark two years after receiving care at Sharp Grossmont. “I still don't have my full stamina, but I am able to go to the gym — at best, six times a week.”

Last November, Mark returned to Sharp Grossmont to thank those who cared for him. He visited the SICU where he was treated.

“It was great meeting everyone again, now with a clear head this time around,” he says. “Dr. Mumtaz happened to be doing her rounds at that time and it was great reliving everything with them. They all remembered me, which was just amazing considering they see so many other patients. I have a greater appreciation of life, and a great respect for what health care providers do on a daily basis.”

Learn more about cardiovascular services at Sharp Grossmont Hospital.

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